| NPI | 1558386086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101237650) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 21699) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2007-07-08 |